Getting the Haves to Come out Behind: Fixing the Distributive Injustices of American Health Care

Hyman criticizes an article by Havighurst and Richman regarding the distributive injustices of US health care. Hyman also offers a guide for implementing policy reforms based on the analysis by Havighurst and Richman

Experience of violation during the past 3 months, social capital, and self-rated health: A population-based study.

Objective: The objective was to investigate the association between experience of violation during the past 3 months and self-rated health, taking trust (social capital), economic stress, and country of birth and parents' country of birth into account. Design/setting/participants/measurements: The 2008 public health survey in Skåne is a cross-sectional study with 55% response rate. A random sample was approached using a postal questionnaire, and 28,198 persons aged 18-80 responded. Logistic regression models investigated associations between experience of violation during the past 3 months and self-rated health. Results: A 27.4% proportion of the men and 30.0% of the women reported less than good health. Less than good health was significantly higher in older age groups, among persons born outside Sweden, with low education, economic stress, low trust in other people, and experience of violation during the past 3 months. The group with experience of violation at one occasion during the past 3 months had odds ratio 1.76 (95% CI 1.57-1.97) of less than good health among men and odds ratio 1.78 (95% CI 1.62-1.96) among women, while the group with experience of violation two or more times during the past 3 months had odds ratio 4.28 (95% CI 3.36-5.44) among men and 3.54 (95% CI 2.89-4.35) among women in the final multiple analyses. Conclusions: Experience of violation during the past 3 months is significantly associated with less than good health, which is a finding with important policy implications

A trait-based plant economic framework can help increase the value of reforestation for conservation

While reforestation is gaining momentum to moderate climate change via carbon sequestration, there is also an opportunity to use tree planting to confront declining global biodiversity. Where tree species vary in support of diversity, selecting appropriate species for planting could increase conservation effectiveness. We used a common garden experiment in Borneo using 24 native tree species to examine how variation among tree species in their support of beetle diversity is predicted by plant traits associated with "acquisitive" and "conservative" resource acquisition strategies. We evaluate three hypotheses: (1) beetle communities show fidelity to host identity as indicated by variation in abundance and diversity among tree species, (2) the leaf economic spectrum partially explains this variation as shown by beetle preferences for plant species that are predicted by plant traits, and (3) a small number of selected tree species can capture higher beetle species richness than a random tree species community. We found high variation among tree species in supporting three highly intercorrelated metrics of beetle communities: abundance, richness, and Shannon diversity. Variation in support of beetle communities was predicted by plant traits and varied by plant functional groups; within the dipterocarp family, high beetle diversity was predicted by conservative traits such as high wood density and slow growth, and in non-dipterocarps by the acquisitive traits of high foliar K and rapid growth. Using species accumulation curves and extrapolation to twice the original sample size, we show that 48 tree species were not enough to reach asymptote levels of beetle richness. Nevertheless, species accumulation curves of the six tree species with the highest richness had steeper slopes and supported 33% higher richness than a random community of tree species. Reforestation projects concerned about conservation can benefit by identifying tree species with a disproportional capacity to support biodiversity based on plant traits

Vägar framåt för några nationella myndigheters implementering av konventionen om biologisk mångfald och lokal och traditionell kunskap av betydelse för biologisk mångfald

På uppdrag av Naturvårdsverket genomförde Centrum för biologisk mångfald under 2014 en utredning, vilket resulterade i denna rapport. Syftet med uppdraget var att göra en fördjupad analys över vilka insatser ett antal svenska statliga myndigheter behöver göra för att uppnå Sveriges åtaganden enligt FN:s konvention om biologisk mångfald vad gäller artikel 8j (särskild hänsyn till s.k. traditionell kunskap som finns hos urfolk och lokala samhällen med traditionella sedvänjor) och artikel 10c (hänsyn till hållbart sedvanebruk). Idén är att de framlagda förslagen ska bidra till att Sverige år 2020 ska nå Aichi-mål 18 gällande dessa frågor, som Sverige varit delaktiga i att besluta om inom mångfaldskonventionen. Traditionell kunskap, dvs. praktisk erfarenhetsbaserad kunskap som förts vidare från generation till generation, bedöms vara en viktig förutsättning för att bevara och hållbart nyttja biologisk mångfald samt uppnå ett framtida hållbart samhälle

A pre-adaptive approach for tropical forest restoration during climate change using naturally occurring genetic variation in response to water limitation

Effective reforestation of degraded tropical forests depends on selecting planting material suited to the stressful environments typical at restoration sites that can be exacerbated by increased duration and intensity of dry spells expected with climate change. While reforestation efforts in nontropical systems are incorporating drought-adapted genotypes into restoration programs to cope with drier conditions, such approaches have not been tested or implemented in tropical forests. As the first effort to examine genetic variation in plant response to drought in a tropical wet forest, we established a watering experiment using five replicated maternal lines (i.e. seedlings from different maternal trees) of five dipterocarp species native to Borneo. Apart from the expected species level variation in growth and herbivory (3-fold variation in both cases), we also found intraspecific variation so that growth in some cases varied 2-fold, and herbivory 3-fold, among genetically different maternal lines. In two species we found that among-maternal line variation in growth rate was negatively correlated with tolerance to water limitation, that is, the maternal lines that performed the best in the high water treatment lost proportionally more of their growth during water limitation. We argue that selection for tolerance to future drier conditions is not only likely to impact population genetics of entire forests, but likely extends from forest trees to the communities of canopy arthropods associated with these trees. In tropical reforestation efforts where increased drought is predicted from climate change, including plant material resilient to drier conditions may improve restoration effectiveness

Antiretroviral therapy adherence strategies used by patients of a large HIV clinic in Lesotho

A high degree of adherence to antiretroviral therapy (ART) in patients infected with human immunodeficiency virus (HIV) is necessary for long term treatment effects. This study explores the role of timing of ART intake, the information patients received from health workers, local adherence patterns, barriers to and facilitators of ART among 28 HIV-positive adults at the Senkatana HIV Clinic in Maseru, Lesotho. This qualitative, semi-structured interview study was carried out during February and March of 2011 and responses were analyzed inspired by the Grounded Theory method. Results were then compared and discussed between the authors and the main themes that emerged were categorized. The majority of the respondents reported having missed one or more doses of medicine in the past and it was a widespread belief among patients that they were required to skip the dose of ART if they were \u201clate\u201d. The main barriers to adherence were interruptions of daily routines or leaving the house without sufficient medicine. The use of mobile phone alarms, phone clocks and support from family and friends were major facilitators of adherence. None of the patients reported to have been counseled on family support or the use of mobile phones as helpful methods in maintaining or improving adherence to ART. Being on-time with ART was emphasized during counseling by health workers. In conclusion, patients should be advised to take the dose as soon as they remember instead of skipping the dose completely when they are late. Mobile phones and family support could be subjects to focus on during future counseling particularly with the growing numbers of mobile phones in Africa and the current focus on telemedicine

Transitioning toward sustainable consumption at the Swedish local governance level

Municipalities have a prominent role to play in the transition to the sustainable society by governing changes at the local level. Based on a quantitative survey of Swedish municipalities, this study has given us a broad perspective on barriers and enablers in Swedish municipalities' efforts to plan, develop, and implement measures for governing the transition to sustainable consumption. By using a classification of municipalities belonging to certain groups, we find that municipalities characterized by having a city at their cores seem to have progressed further in their work to address sustainable consumption than municipalities characterized as more rural or as commuting municipalities near cities or towns. We also find that, though a large share of municipalities in Sweden report working systematically on sustainable consumption, their potential appears to not be fully realized, limited primarily by a lack of political support and key resources. We identify opportunities to establish more responsive governance structures as important for addressing these issues, where interactions at multiple levels are required to achieve successful governance of Sweden's work on sustainable consumption and address the barriers identified by this study. Higher levels of governance should offer greater support and guidance to municipalities in their work. We also advocate for more robust collaborations between municipalities to prevent them from working in isolation, build capacity, and foster greater knowledge exchange between municipality groups. This would strengthen municipalities' ability to catalyze transformational change, which is crucial if they are to meet their own high ambitions related to sustainable consumption and help institute the changes needed to enable the fulfillment of the long-term sustainability challenges we face, such as those articulated in the Paris Agreement and the 2030 Agenda for Sustainable Development